Neurological comorbidity and severity of COVID-19

Romagnolo, Alberto; Balestrino, Roberta; Imbalzano, Gabriele; Ciccone, Giovannino; Riccardini, Franco; Artusi, Carlo Alberto; Bozzali, Marco; Ferrero, Bruno; Montalenti, Elisa; Montanaro, Elisa; Rizzone, Mario Giorgio; Vaula, Giovanna; Zibetti, Maurizio; Lopiano, Leonardo

doi:10.1007/s00415-020-10123-y

Cited by 51 publications

(45 citation statements)

References 27 publications

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“…Severe disease. Ten studies reported severe disease as an outcome in COVID-19 patients (19,(54)(55)(56)(57)(58)(59)(60)(61)(62). The definition of severe disease, however, varied among studies.…”

Section: Resultsmentioning

confidence: 99%

Comorbidities in SARS-CoV-2 Patients: a Systematic Review and Meta-Analysis

Tipih

Aminake

et al. 2021

mBio

260

175

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread across the globe at unprecedented speed and is showing no signs of slowing down. The outbreak of coronavirus disease 2019 (COVID-19) has led to significant health burden in infected patients especially in those with underlying comorbidities. The aim of this study was to evaluate the correlation between comorbidities and their role in the exacerbation of disease in COVID-19 patients leading to fatal outcomes. A systematic review was conducted using data from MEDLINE, Scopus, Web of Science, and EMBASE databases published from 1 December 2019 to 15 September 2020. Fifty-three articles were included in the systematic review. Of those 53 articles, 8 articles were eligible for meta-analysis. Hypertension, obesity, and diabetes mellitus were identified to be the most prevalent comorbidities in COVID-19 patients. Our meta-analysis showed that cancer, chronic kidney diseases, diabetes mellitus, and hypertension were independently associated with mortality in COVID-19 patients. Chronic kidney disease was statistically the most prominent comorbidity leading to death. However, despite having high prevalence, obesity was not associated with mortality in COVID-19 patients. IMPORTANCE COVID-19 has plagued the world since it was first identified in December 2019. Previous systematic reviews and meta-analysis were limited by various factors such as the usage of non-peer reviewed data and were also limited by the lack of clinical data on a global scale. Comorbidities are frequently cited as risk factors for severe COVID-19 outcomes. However, the degree to which specific comorbidities impact the disease is debatable. Our study selection involves a global reach and covers all comorbidities that were reported to be involved in the exacerbation of COVID-19 leading to fatal outcomes, which allows us to identify the specific comorbidities that have higher risk in patients. The study highlights COVID-19 high-risk groups. However, further research should focus on the status of comorbidities and prognosis in COVID-19 patients.

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Section: Resultsmentioning

confidence: 99%

Comorbidities in SARS-CoV-2 Patients: a Systematic Review and Meta-Analysis

Tipih

Aminake

et al. 2021

mBio

260

175

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“…After the initial screening, 158 were excluded for not meeting the inclusion criteria, leaving 75 articles to assess for eligibility. After evaluation of the full-text articles, eight met the inclusion criteria 3,4,[11][12][13][14][15][16][17][18][19] and were thus included into the final analysis ( Figure 1).…”

Section: Search Results and Included Studiesmentioning

confidence: 99%

“…1 Over the first 6 months of 2020, several risk factors have been associated with a poor prognosis among COVID- 19 patients, including preexisting neurological disease and advanced age. 2,[3][4][5][6] It should be underscored that, despite dementia represents a common clinical condition, affecting up to 7% of elderly subjects worldwide 7,8 only a few attentions have been posed by medical research on the impact of this disease in elderly COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

Dementia and the risk of death in elderly patients with COVID‐19 infection: Systematic review and meta‐analysis

Zuin

2020

Int J Geriat Psychiatry

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Objectives: The COVID-19 infection represents a global public health emergency worldwide. Several risk factors have been associated with a poor prognosis among COVID-19 patients. We aimed to perform a systemic review and meta-analysis to evaluate the mortality risk in elderly patients with dementia and COVID-19 infection. Methods: Literature search was based on Cochrane Library, Embase, PubMed, and Google Scholar to locate articles published between December 2019 and July 2020, presenting the number of survived versus deceased patients with dementia and COVID-19 infection. Results: A total of 233 articles were retrieved: 158 were excluded for not meeting the inclusion criteria, leaving 75 articles to assess for eligibility. After evaluation of the full-text articles, eight met the inclusion criteria and were thus included into the final analysis (6493 patients-mean age: 69.6 years). Among COVID-19 patients, the prevalence of dementia was higher in non-survivors compared with survivors (17.5% vs. 5.4%, p < 0.001). The pooled analysis performed using a random-effect model showed an increase in the risk of death in COVID-19 patients with dementia (odds ratio: 3.75; 95% confidence interval: 2.54-5.54, p < 0.0001, I 2 ¼ 49.5%). The Egger's regression test confirmed that there were not statistically evidences of publication bias (t ¼ 0.059; p ¼ 0.954). Conclusions: Our preliminary results suggest that patients with COVID-19 infection and dementia have a higher mortality risk in the short-term period compared with infected non-demented individuals. Due to their intrinsic frailty, dementia patients may require a more aggressive treatment and prompt isolation to improve their short-term outcome.

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“…Of the 423 patients with severe COVID-19, 20 (4.7%) had preexisting neurological comorbidities, with cerebrovascular disease (8 patients) being the most common. Preexisting cerebrovascular disease has been associated with a more severe form of COVID-19 and an increased risk of invasive mechanical ventilation and death [ 11 , 12 ]. Poliomyelitis was the second most common neurological comorbidity associated with severe COVID-19 (4 patients).…”

Section: Neurological Comorbidities and Neurological Symptoms Associamentioning

confidence: 99%

Neurological issues during severe COVID-19 in a tertiary level hospital in Western India

Dravid

Mane

Khan

2021

Neuroscience Letters

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Background India has the second largest COVID-19 epidemic in the world as per current estimates. Central and peripheral nervous system involvement in COVID-19 (Neuro COVID-19) has been increasingly identified and reported. This letter is the first report of the spectrum of neurological disorders observed in patients with severe COVID-19 from a resource limited setting like India. Till October 30 th 2020, Noble hospital and research center, Pune, India has admitted 2631 patients of COVID-19. Out of these, 423 patients had severe COVID-19. Neurologic complications in severe COVID-19 in Pune, India Of the 423 patients with severe COVID-19, 20 (4.7%) had pre-existing neurologic co-morbidities, with cerebrovascular disease (8 patients) being the most common. Poliomyelitis (4 patients) was also an important co-morbidity associated with severe COVID-19. Bodyache or myalgia (207/423, 49 %) and headache (59/423, 13.9 %) were the most common neurologic symptoms observed in patients. Encephalopathy (22/423, 5.2 %) and new onset large vessel ischemic stroke secondary to cerebral artery thrombosis (5/423, 1.1%) were the most common secondary neurologic complications noted in our cohort. Two cases of COVID-19 / central nervous system tuberculosis co-infection were also identified. Challenges in management of Neuro COVID-19 in India Various challenges like an overwhelmed health care system, inadequate workforce, lack of exhaustive reporting of symptoms and poor availability of neuroimaging in ventilated COVID-19 patients leads to underestimation of Neuro COVID-19 in resource limited settings like India.

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Neurological comorbidity and severity of COVID-19

Cited by 51 publications

References 27 publications

Comorbidities in SARS-CoV-2 Patients: a Systematic Review and Meta-Analysis

Comorbidities in SARS-CoV-2 Patients: a Systematic Review and Meta-Analysis

Dementia and the risk of death in elderly patients with COVID‐19 infection: Systematic review and meta‐analysis

Neurological issues during severe COVID-19 in a tertiary level hospital in Western India

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